Department of Endocrinology, Metabolism and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.
Nephrol Dial Transplant. 2010 May;25(5):1554-9. doi: 10.1093/ndt/gfp694. Epub 2009 Dec 27.
Gradient-echo T2*-weighted magnetic resonance imaging (T2*-weighted MRI) is highly sensitive for detecting cerebral microbleeds (CMBs). CMBs have been reported to be a risk factor for future cerebrovascular events and a marker of cerebral small vessel disease in the general population. Chronic kidney disease (CKD) is an independent risk factor for cardiovascular disease. The relationship between CKD and CMBs, which has not been clarified to date, is examined.
In this cross-sectional study, T2*-weighted MRI of brain was performed with a 1.5-T MRI system in 162 CKD patients (CKD stages 1-5, excluding CKD stage 5(D)) and 24 normal subjects.
CMBs were found in 35 CKD patients (25.6%), but not in control subjects. CMBs were more prevalent in male patients, in those with higher blood pressure, advanced age and poor kidney function. There was a significant association between the prevalence of CMBs and the CKD stage, with higher prevalence of CMBs as the CKD stages advanced (P < 0.01). Estimated glomerular filtration rate was a significant factor associated with the prevalence of CMBs, independent of age, gender and hypertension. There was no significant relationship between CMBs and the presence of diabetes mellitus and dyslipidemia.
Decreased renal function is a significant risk factor for CMBs, independent of the presence of hypertension. Poor kidney function could be associated with future cerebrovascular events.
梯度回波 T2*-加权磁共振成像（T2*-weighted MRI）对检测脑微出血（CMBs）非常敏感。CMBs 已被报道为未来脑血管事件的危险因素，也是普通人群中小血管疾病的标志物。慢性肾脏病（CKD）是心血管疾病的独立危险因素。目前尚未阐明 CKD 和 CMBs 之间的关系，本研究对此进行了检查。
在这项横断面研究中，使用 1.5-T MRI 系统对 162 例 CKD 患者（CKD 1-5 期，不包括 CKD 5(D)期）和 24 名正常对照进行了脑 T2*-weighted MRI 检查。
在 35 例 CKD 患者（25.6%）中发现了 CMBs，但在对照组中未发现。CMBs 在男性患者、血压较高、年龄较大和肾功能较差的患者中更为常见。CMBs 的患病率与 CKD 分期之间存在显著相关性，随着 CKD 分期的进展，CMBs 的患病率更高（P < 0.01）。估计肾小球滤过率是与 CMBs 患病率相关的重要因素，独立于年龄、性别和高血压。CMBs 与糖尿病和血脂异常的存在之间无显著关系。
肾功能下降是 CMBs 的重要危险因素，与高血压的存在无关。肾功能差可能与未来的脑血管事件有关。
